The broad, overall objective of this Program Project is to study the management of urinary incontinence in noninstitutionalized women. This program will collect psychosocial, functional, medical, pathophysiological, and efficacy data related to the diagnosis and management of urinary incontinence. The specific aims are: 1)Compare the efficacy of three forms of behavioral therapy: bladder training, pelvic muscle exercises, and bladder training with concomitant pelvic muscle exercises. 2)Assess the efficacy of estrogen supplementation in the management of the syndrome of urinary incontinence. 3)Confirm the mechanism by which surgical intervention affects different outcomes in patients with urinary incontinence and severe genital prolapse. There are three subprojects in this Program: behavioral (subproject 1, estrogen supplementation (subproject 2), and surgical (subproject 3). Subprojects 1 and 2 will be conducted at two sites: Medical College of Virginia/Virginia Commonwealth University and Bowman Gray School of Medicine/Wake Forest University. Subproject 3 will be conducted at Medical College of Virginia only. Information from this project will be instrumental in improving the management of urinary incontinence, and improve selection of diagnostic procedures and interventions with maximal limitation of inconvenience, side effects, costs, and complications.